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Patients' experiences of isolation in psychiatric inpatient care: insights from a meta-ethnographic study
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-3360-5589
Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0001-8801-5423
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-9116-5569
Umeå University, Faculty of Medicine, Department of Nursing. Department of Health Sciences, University West,Trollhättan, Sweden.
2019 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 1, p. 7-21Article in journal (Refereed) Published
Abstract [en]

Historically, people with mental ill-health have been isolated from society. Although mental health care has moved from closed to more open forms of care, in many societies care is still provided in locked wards, and people with mental ill-health are sometimes secluded from their fellow patients, families, friends, and visitors. The aim of this study was to illuminate patients' experiences of isolation in psychiatric inpatient care. A systematic review of qualitative research was conducted, and the key findings were subjected to meta-ethnographic synthesis. The findings were twofold: 'being admitted to prison' and 'having access to shelter'. The experience of isolated care as prison-like symbolizes patients' longing for freedom and feeling restricted and limited by rules, stripped of rights, abandoned, controlled, powerless, and unsupported. In contrast, the experience of isolation as shelter symbolizes safety and the opportunity to regain control over one's own situation. A stigmatizing public view holds that people with mental ill-health are dangerous and unpredictable and, therefore, unsafe to themselves and others. Being placed in isolation because these fears contribute to self-stigma among patients. Promoting a sheltered experience in which isolation is used with respect for patients and the reasons are made explicit may encourage recovery. A shift in emphasis in ward culture from observation to engagement is needed to reduce blame, shift patient experiences from prison to shelter, and to support autonomy as a therapeutic intervention.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 28, no 1, p. 7-21
Keywords [en]
experiences, isolation, locked ward, psychiatric inpatient care, seclusion
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-154952DOI: 10.1111/inm.12519ISI: 000459619300002PubMedID: 29975446OAI: oai:DiVA.org:umu-154952DiVA, id: diva2:1275558
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-03-27Bibliographically approved

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Lindgren, Britt-MarieRingnér, AndersMolin, JennyHällgren Graneheim, Ulla

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